Septic Shock pp 116-128 | Cite as

The Role of Proteolytic Enzyme Systems with Particular Emphasis on the Plasma Kallikrein-Kinin System During Septicemia and Septic Shock

  • A. O. Aasen
Part of the Update in Intensive Care and Emergency Medicine book series (UICM, volume 4)


Both in endotoxin shock in experimental animals and during septicemia in man pronounced proteolytic activity of plasma has been observed. Proteolytic involvement in this state due to activation of the coagulation and the fibrinolytic system was detected many years ago [1, 2]. Some early studies also suggested that the kallikrein-kinin system might be of significance for the pathophysiological changes seen [3, 4]. Clinical studies performed during the seventies provided more solid data which put particular emphasis on activation of the kallikreinkinin and complement systems for the development of shock and death during endotoxemia [5–7]. In a study on soldiers wounded in battle during the Vietnamese war, it was observed that blood samples obtained from those who died of gram-negative septicemia had very low contents of high molecular weight kininogen [7]. In the patients surviving gram-negative septicemia, the blood kininogen levels, after an initial lowering, rose towards normal values.


Septic Shock Plasma Kallikrein High Molecular Weight Kininogen Kinin System Proteolytic Enzyme System 
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© Springer-Verlag Berlin Heidelberg 1987

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  • A. O. Aasen

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